| Paul Innis Dmd Inc | |
|
6584 N. Creekside Lane Park City UT 84098 | |
| (435) 649-6332 | |
| Not Available |
| Full Name | Paul Innis Dmd Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6584 N. Creekside Lane, Park City, Utah |
| Authorized Official Name and Position | Paul Innis (PRESIDENT) |
| Authorized Official Contact | 4356496332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Innis Dmd Inc Po Box 681179 Park City UT 84068-1179 Ph: () - | Paul Innis Dmd Inc 6584 N. Creekside Lane Park City UT 84098 Ph: (435) 649-6332 |
| NPI Number | 1164624110 |
|---|---|
| Provider Enumeration Date | 06/01/2007 |
| Last Update Date | 03/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164624110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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